Friday, July 27, 2012




On Health Care, Ignorant



Misinformation, disinformation, and manipulation are the order of the day in Republican media.    Fox News, for instance, has been implying for years that Barack Obama is a Muslim, with its employees claiming he attended a madrassa as a child or "had a Muslim upbringing" or "went to a Muslim school."    That campaign has been a success as indicated by the recent Pew Research Center poll, which found 48% of Americans believing Obama is a Muslim or not being certain of his religion.

There are other reasons so many people are unconvinced that Obama, whom we were reminded in 2008 incessantly had attended the United Church of Christ congregation in Chicago of Reverend Jeremiah Wright, is a member of a Christian denomination.    But the failure, intentional or otherwise, to supply conservative audiences accurate information is a major factor.

A similar example, one in which listeners were probably misinformed unintentionally, turned up on Rush Limbaugh's program Thursday.     Complaining about a new CBO report maintaining that there will be a greater reduction in the deficit from the Affordable Care Act than previously projected, Rush stated

And, lo and behold, now it's gonna cost $84 billion less than what we thought.  Now, they do note that this is largely due to the Supreme Court allowing states to opt out of expanding Medicare, as was required under Obamacare.  The states can opt out.  But what does that mean?  The states opt out of Medicare, it means that this savings is only due to fewer people getting free health insurance from the government, quote, unquote.  But you would never know that from The Hill's headline or any of the other headlines in the mainstream media about this. 

The only reason there are cost savings is because fewer people are gonna get access, fewer people are gonna get covered.  You know, we spent a lot of time shortly after the Supreme Court ruling -- I hope you were here.  I hope you remember it.  We spent a lot of time explaining all of the intricacies of the exchanges.  The states are required by Obamacare to set up their exchanges, but they don't have to.  The states get subsidized by the federal government, they set up the exchange.  The federal government cannot fund its own exchange.  It was a mistake that the writers of the law made.  They goofed up.  And the states -- people are reading this literally -- the states, with the freedom they have to opt out of Medicare and to not set up exchanges, have the ability to deal Obamacare a serious blow.  Because the law does not permit the federal government to come in and take over and do what the states might refuse to do. 


So one of the original purposes of Obamacare was to off-load additional costs to the states by having them pick up Medicare increases.  But the Supreme Court ruling said that states can opt out of that if they want to, and I think 26 or 27 states will, or have said they're going to.


In March, 2010 twenty-six states filed suit against the federal government, alleging that the Affordable Care Act included two unconstitutional provisions:   the mandate that everyone obtain health insurance and the requirement that states expand their Medicaid program or lose all federal funding for Medicaid.   The Court, as we all know, ruled against the plaintiffs in the former matter and in their favor in the latter.

Cost reductions to Medicare are, and have been expected, to allow the legislation to cut, rather than increase, the federal budget deficit.    The likelihood that there will be even greater savings, which the CBO estimated in its latest report, is due to the revolting possibility that many of the original 26 states will opt out of expanding their Medicaid program.    A New York Times article, "Court's Ruling May Blunt Reach of the Health Law"- to which Limbaugh specifically refers in his commentary- explains

While it is not yet clear how many states will ultimately opt out of the expansion, the budget office said it now predicted that six million fewer people would be insured by Medicaid, the federal-state program for low-income people. Half of them, it said, will probably gain private insurance coverage through health insurance  exchanges to be established in all states.

On balance, the budget office said, in 2022, “about three million more people will be uninsured” than under its previous estimates. It now says that 30 million people will be uninsured in 2022, against its estimate of 27 million before the Supreme Court decision.


The report estimates that 53 million people are now uninsured and that 60 million would be uninsured in 2022 if the law was repealed, as Republicans in Congress have proposed.


With the expected changes as a result of the court decision, the budget office said the law would cost $84 billion less than it had previously predicted.


“The insurance coverage provisions of the Affordable Care Act will have a net cost of $1,168 billion over the 2012-2022 period — compared with $1,252 billion projected in March 2012 for that 11-year period — for a net reduction of $84 billion,” or about 7 percent, the budget office said.


"The budget office," the reporter noted, "said it now predicted that six million fewer people would be insured by Medicaid," lowering the cost of health care because fewer poor people would be covered.   Yet Rush inexplicably remarked that the CBO argues

that this is largely due to the Supreme Court allowing states to opt out of expanding Medicare, as was required under Obamacare.  The states can opt out.  But what does that mean?  The states opt out of Medicare, it means that this savings is only due to fewer people getting free health insurance from the government, quote, unquote.

He doesn't stop there, moments later contending

So one of the original purposes of Obamacare was to off-load additional costs to the states by having them pick up Medicare increases.  But the Supreme Court ruling said that states can opt out of that if they want to, and I think 26 or 27 states will, or have said they're going to.

A few Republican governors have vowed they will not expand their Medicaid program, and Rush clearly hopes all of the 26 states which had filed suit (in part because of the Medicaid requirement) will refuse to increase coverage.       Limbaugh interprets that as "opt out (of) Medicare increases."

Presumably, Rush is intentionally misleading his audience by casually stating "Obamacare was to off-load additional costs to the states by having them pick up Medicare increases."   In reality- a world the blowhard refuses to visit- the states would have to "pick up" roughly 10% of the increase.  

But- apparently uninformed or confused- Limbaugh uses "Medicare" instead of "Medicaid" at least four times.   (It's hard to determine whether his final reference to Medicare, in the last line of the transcript, refers to the Medicaid program or the Medicare program.)    Consider:  the man gets fifty million dollars per year ($50,000,000) and mistakes a federal-state, needs based program of health care for a federal health insurance program primarily for the elderly.       
What a country!




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